32C-140 UNIT A BP-2023-0942
351 PLEASANT ST UNIT COMMONWEALTH OF M SSACHUSETTS
A
Map:Block:Lot: CITY OF NORTHA PTON
32C-140-001
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGI TERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARA TY FUND (MGL c.142A)
BUILDING P .RMIT
Permit# BP-2023-0942 PERMISSION IS HEREBY GRANTED TO:
Project# REPAIR 2023 Contractor: License:
Est. Cost: 15000 MARK SMITH 104325 '
Const.Class: Exp.Date: 12/13/202
Use Group: Owner: MILL AMC PLACE CONDOMINIUM ASSOC
Lot Size (sq.ft.)
Zoning: GB Applicant: WOOD MITHS
Applicant Address Phone: Insurance:
5 ANNA ST (413)531-7342 6559UBIK519265
WARE, MA 01082
ISSUED ON: 07/19/2023
TO PERFORM THE FOLLOWING WORK:
REPAIR STOREFRONT
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter: Footings:
Rough: Rough: House# Foundation:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NO' THAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: 1 Ti
Ip,
.52 .
r
, ,
Fees Paid: $105.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commiss oner
RECEIVED
The Commonwealth of Massach se s JUL 1 8
2023
Office of Public Safety and Inspectio
Massachusetts State Building Code(780 )
Building Permit Application for any Building other than a One or-EF '
(This Section For Official Use Only) NORTHAfMPTON!MA.010601 NS
Building Permit Number: .3- Qy.7 Date Applied: Building Official:
SECTION 1:LOCATION
351 Pleasant Street Northampton 01060 Millbank Place#1 Condominium(UPS Storefront)
No.and Street City/Town Zip Code Name of Building(if applicable)
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below
Existing Building® Repair® Alteration 0 Addition 0 Demolition El (Please fill out and submit Appendix 2)
Change of Use 0 Change of Occupancy 0 Other 0 Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No la
Is an Independent Structural Engineering Peer Review required? Yes 0 No
Brief Description of Proposed Work:
Repair of storefront damaged by accident.Remove existing storefront window framing elements,rebuild as necessary,repalce casement windows.No alteration
to pre-existing finishes is planned.
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0
Existing Use Group(s): . Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) 3
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 , B: Business E: Educational 0
F: Factory F-1 0 F2❑ H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0
I: Institutional I-1 0 I-2❑ I-3❑ I-4❑ M: Mercantile 0 R Residential R-10 R-2 0 R-3 0 R-4 0
S: Storage S-1❑ S-2❑ U: Utility 0 Special Use 0 and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA 0 IB 0 IIA0 IIB 0 MA CI IIIBC IV 0 VA 0 VB 0
SECTION 7:SITE INFORMATION(refer to 780 CMR 106.3 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal:
Public 0 Check if outside Flood Zone 0 . Indicate municipal❑ A trench will not be Licensed Disposal Site 0
Private CIor indentify Zone: or on site system 0 required 0 or trench or specify:
permit is enclosed 0
Railroad right-of-war Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable 0 Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed 0 Yes❑ or No 0 Yes 0 No 0
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction:
Does the building contain an Sprinkler System?: Special Stipulations:
Design Occupant Load per Floor and Assembly space:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
Millbank Place Condominium Association 351 Pleasant Street Northampton 01060
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information
Jon McGee/Agent of Board of Trustees _ 413 320 5070 JMCGEE@HPMGNOHO.COM
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes:
Mark Smith 5 Anna Street Ware MA 01082
Name Street Address City/Town State Zip
to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0_
Otherwise provide construction control forms(see section 107 in the code)as required.
10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals)
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Repair of storefront da i �vu��e�xi mdow framing elements,rebuild as necessary,repalce casement windows.No alteration
asdfR 14�q1���o
Company Name
OP4--- Sk rrik 6%5 • I 04'3 t5
Name of Person Res ons' le for Constru n License No. and Type if Applicable
P� `rta� • V�pcf N Pk 0 i 081--
4 - '
reet Address City/Town State Zip
� *i- 4 - - �ooi�SMt- -67 C�cc nnc �:iscf
Telephone No.(business) Telephone No.(cell) e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6))
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit.
Is a signed Affidavit submitted with this application? Yes 0 No CI
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$
1.Building $ I k 000 . Building Permit Fee=Total Construction Co (Insert here
2.Electrical $ appropriate municipal factor) ',
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (con r. - unicipality)
5.Mechanical (Other) $ Enclose check payable to
6.Total Cost $ (contact municipality)and write check number here 6 V
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
application is true and accurate th st of my ledge and understanding.
f..Y.- 5nIL Ik • - c2— by E•cr 413 C- i 1 l t z ,
Please rint rld sign nam�-i Title Telephone No. Date
p&it.)A J� • Pis- 64 F- D(QV-
Street Address City/Town State Zip Email Address
Municipal Inspector to fill out this section upon application approval: //e 7- I q-ZOZ3
Name Date
City of Northampton
cfajTJtS►i�A.
r MassachusettsDEPARTMENT OF BUILDING INSPECTIONS212 Main Street 40Municipal Building11,,
Northampton, MA 01060 15 :::
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGLc 111, S 150A.
The debris will be disposed of in:
Location of Facility: \2furl t CIS (K1
The debris will be transported by:
Name of Hauler: 0 )v t ` Siui.e S
i C;A1L--
Signature of Applicant: ' � 4 pp g Date: fig iZ-
ores
The Commonwealth of Massachusetts
lkB" Department of Industrial Accidents
r "' 1 Congress Street,Suite 100
` azA
oston,.ILa 02114-2017
w ww mass.gov/dia
"yit ur kers'( ompensation Insurance Militias it:Builders/Contractors/Electricians/Plumbers.
-ID BE FILED WITH THE PERMUTING s(;AI 111ORTIA.
Annlicant Information /� ,�j�, Please Print I.eeihls
Name(BusinesstkgamrationIndividuall: I/s.j M6 1"1AR 5vtl tt
Address: 5 AN.-lak SE .
C'ity'State Zip: ct • MA • OIOV- Phone#: 1113 G3v'`134l-
ire yan an eaapMyell(heck the appropriate box:
Type of project(required):
I 1 ant a employer uith entployres(lull mid or part-tirtr 1,
7. O Ness construction
am a sole proprsetu or pann aship and hale no cur!ow s tsurking for nor m_. $. Remodeling
�� any capac-at)-(No%takers'comp.insurance eapw.af.j
30 I am a honavwncr Jewng all ikon,m ts un4+oco:11.(No suias'c .utsuruk u e requeal j'
9. a Demolition
111 D Building addition
4.01 am a homeowner r and Will b.hums.varaclurs to conduct all nowt.on on my prupern I%ill
�--i ctitsure that all contractors either ha w.nkcrx"thorn rmation'murancr.a are vote I la Electrical repairs or additions
prupnetun with no employers.
12.0 Plumbing repairs or additions
5C3 I am a cc-octal contractor and 1 have hued the soh-cotitrackos fisted on the attached sheet..
13.aRoot
ilk,:subtiawuacicm base employe,s and have workers'comp.insurance.'
14.®Other LM
b.E3 1h c area corporation and its officers have exercised thew night of exemption per M(il_C.
1 S 2.i If is.and we have no employers.(No ourkers'comp.insurance required-)
*Any apphcait that chucks box#1 mita also till art the suction helots%bowatj&air worker,-eornplmiliaa policy information..
s Ihnnwwnem whoa ld&this affidavit unticei0gthey wedumg all%az imutd o bin oo►stde.swilracaeraMilled mahout a two affalasit mdn-atitg such.
:Contractors that eib dr/lint box must atsedrtlrlll adiianet thee thaw*)Air wan oldie sub-aw.lrl ista and sore sv halter ur not thou:moues have
rntpktyees. If the fiorrlrreken haste a play ea.they ram pros i&ihtir ttaadosse amp.pulley yearbeit.
I am on employer Mae is yeemi los waiters'compensation instawtcafor my employees. Beim I s the p.&y sod Peak
iafarmtian.
rAVe(Insurance Company Name: (...(—S '4-44S .
Policy#or Self-ins.Etc..: (AI • ( t^- 5 11 L 10-3 iiIparation Date: I l — 2-4-
Job Site Address: .� V Go St.. Cite State Zip:.OCICTIAAY11tg)A4
Attach a copy of the ssorkers'compensation policy declaration page(shooing the policy number and espiratios date).
Failure to secure coy crag:as required under SAW. s:- 152.�25A is a criminal'tolation punishable by a tine up to$1,500.00
and or one-year imprisonment.as t,ell as cis it penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a
day against the s iolator-A copy of this statement niay.be Forwarded to the(Mice of Investigations of the 1)IA for insurance
coverage verification.
I do hereby •under e l� penalties of perjury that the information provided above is true and correct
Signature: Date: '71(8 12
Phone#: b I 7 34 Z
1 Official use only. Do not write in this area.to be completed ay city or town official
City or Town: Permit/License#
Issuing Authority (circle one):
I.Board of Health 2.Building Department 3.('ity dowa Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other _
I
Contact Person: — _ Phone#:
Commonwealth of Massachusetts
Division of Occupational Licensure
Board of Building Re ulations and Standards
Cons lontr*,rvisor
CS-104325 spires: 12/13/2023
MARK E SMITH
5 ANNA STF*ET
WARE MA 01982
mil, t l�
Commissioner du,G K L7Eeriaza.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR
TYPE:Individual
Registration Expiration
118961 05/09/2025
MARK E SMITH
D/B/A WOODSMITHS
MARK E.SMITH
5 ANNA ST r,/,,"'`dGG.i/ /etc'
WARE,MA 01082
Undersecretary